Prescription Drugs’ List Price Up 6.6% In Just 3 Weeks


Drug makers typically raise their prices in the beginning of the year and 2022 has been no exception.  A new study found that about 150 drug makers raised prices on 866 products in the U.S. during the first three weeks of the year by 6.6%.  That’s slightly less than the overall inflation rate of 7% over the past year, but there still may be more drug price hikes on the way.  Therefore, it’s possible that this could be a record year for drug price increase.  Some of the numbers have been eye popping, such as the 536% increase Exelan Pharmaceuticals implemented for its generic high blood pressure treatment Lisinopril.

Medicare Agrees To Cover 8 Home COVID Tests Per Month

A close up of many viruses on a red background


Medicare is usually the leader on what sort of medications are approved for payment, with private insurance companies typically following suit.  Not this time.  It was weeks after President Joe Biden said private insurance companies had to cover the cost of at-home COVID test that finally Medicare announced it would cover up to 8 tests per home per month.  Medicare will pay pharmacies and other entities directly to allow enrollees to pick up the free tests. Until the tests become available in drug stores, you can order them at wwww.CovidTests.gov.

https://www.usatoday.com/story/news/health/2022/02/03/medicare-cover-free-covid-19-home-tests-starting-spring/6647349001/

Telehealth Has Become The Norm For Seniors During The Pandemic

A person holding a stethoscope in front of a laptop.


Telehealth has become a normal part of the daily life of seniors, although there has been a big behind the scene battle being played out as Medicare has threatened to stop reimbursing for these visits once the pandemic has lifted.  However, with the new Omicron strain of COVID-19 spreading like wildfire, for now, at least, Medicare has backed down and extended coverage of remote health care through at least 2023.  Granted, it does have its limitations.  For instance, patients and physicians worry that the lack of face-to-face visits won’t allow the doctor to pick up on subtle clues about the patient’s health that body language might reveal with a personal visit.  However, with 52.7 million Medicare visits clocked last year versus only 840K in 2019, clearly something is working!

Carmel, CA Medicare Elder Abuse Alert

An old woman with a bruised eye and hand on her face.


There is never a shortage of elder abuse scams making the rounds, but the latest to hit our area is Medicare related.  You will receive a message that says “Hi, this is Becky, your patient advocate working closely with Medicare.  Currently, Medicare is offering precautionary genetic cancer screening nationwide and has recommended that anyone over the age of 50 be tested.  These tests help to detect early signs of cancer and are covered by your insurance.  If you do not act soon, Medicare may label you as ineligible for coverage.  Please press 1 to speak to a specialist.â€Â  The situation is so dire that AARP The Magazine (August/September Issue, Page 32) ran a two-page story on it.  Do not fall for this scam!  If you have any questions, call the AARP Fraud Watch Network’s helpline at 877-908-3360.

Good News For Those On Social Security, Some Medicare Advantage Plans Lowering Prices – By Derek Baine

A table with many different types of pills on it.


Social Security recipients recently got the good news that come January, their cost of living adjustment (COLA) will rise more than it has in decades.  Now more good news as, according to the Centers for Medicare & Medicaid Services (CMS), the average monthly premium for a Medicare Advantage (MA) plan is projected to drop 11% in 2022 to just $21.22.  The CMS also projected that Medicare enrollees who buy Part D drug coverage will see their premium rise from $31.47 this year to $33 next year (Source AARP Bulletin, November 2021 Issue, page 4).

AARP Gets Centers For Medicare & Medicaid Services To Regulate Nursing Homes More Stringently : By Derek Baine

A building with the capitol in the background.


The AARP Foundation and other advocates agreed to amend a lawsuit against CMS after the agency which regulates nursing facilities, agreed to reinstate the ability to levy steep finds to hold nursing homes accountable for the health and safety of residents.  Previously, nursing homes could be fined only once per violation.  Under the new rules, the CMS can levy fines on a facility for every day they are or were in violation of the rules (Source AARP Bulletin, November 2021 Issue, page 4).

Choose Medicare Advantage Plans Carefully

A building with the capitol in the background.


Once per year, Medicare recipients have a chance to change their Medicare Advantage policy, and they also have the chance to buy a Medigap insurance policy anytime between October 15 and December 7.  But choose carefully.  Although Medicare Advantage policy benefits are pretty transparent, switching to a Medicap policy does carry significant risks.  In most states, Medigap insurers can turn you down due to preexisting conditions, or charge you more based on your health or age.  Don’t cancel your Medicare Advantage policy in favor or a Medigap policy until you fully understand the financial implications.

Great News For Medicare Recipients In New Senate Bill


Many had criticized Congress for working on a sweeping bill that, at the end of the day, did not include relief for consumers over the high cost of prescription drugs.  That has been quickly remedied.  A deal was reached today which adds to the $1.85 trillion social-policy and climate bill a provision which gives Medicare the power to negotiate the price of some drugs, penalize drug companies for raising prices faster than inflation, and cap out-of-pocket costs for seniors at $2,000 per year.  It also creates a $35 out-of-pocket monthly maximum for insulin.  “This deal will directly reduce out-of-pocket drug spending for millions of patients,†said Senate Majority Leader Chuck Schumer (D., N.Y.).

Carmel, CA Telemedicine Is Here To Stay, Says Medicare

A person holding a stethoscope in front of a laptop.


More than three times as many Medicare beneficiaries had access to their doctors via a phone or video visit during the pandemic than before, a trend which is likely to continue with the new COVID-19 variant causing another surge in coronavirus cases.  The Kaiser Foundation, which recently conducted a study on this issue, said that expanded telehealth care is really good news for people of color, those with disabilities and low income families.   Those living in rural areas had difficulty getting to the doctor even before coronavirus.  Believe it or not, Monterey County is considered rural and indeed in South and North County populations are spread out over quite a large footprint. Thankfully, in early 2020, Medicare expanded coverage of such visits to enable all enrollees to keep up with their medical care while minimizing their risk of exposure to the coronavirus.  Although the rules only extend through the end of 2021, there are a number of bills in Congress which would make telehealth coverage permanent.

https://www.aarp.org/health/medicare-insurance/info-2021/telehealth-increase-covid-pandemic.html